Tuesday, March 26, 2013

Preeclampsia Postpartum

A lot of people have been asking how I've been doing, so I thought I'd give an update on my health issues. As I noted before, I did little research on postpartum problems; I researched pregnancy and skipped right ahead to child development. When I started having cramps and severe headaches last week, I did a cursory web search to find that these problems aren't unusual in the postpartum (after birth) stage, so initially I wasn't worried.

However, when the problems continued to persist, I made an appointment with my doctor to make sure everything was okay. They were concerned I may have had an appendicitis, so I was sent for an ultrasound for my abdomen. When the ultrasound turned out normal, they sent me for more blood work which turned up nothing. They had no idea why I was having these problems, and suggested I see my general practitioner or go to the ER.

I was reluctant to go to the ER, but when the jack hammer in my head wouldn't stop, the hubby and I decided a trip to the hospital was necessary. So we woke up early Saturday morning, and the hubby, Cora, and I went to the same hospital where she had been born two weeks before.

I was admitted to the ER with unusually high blood pressure. Always having good blood pressure, I did not realize at the time that my blood pressure was dangerously high, reading 220/110. They immediately sent me for a CT scan. Because of the dye used, I wasn't allowed to nurse Cora any longer, so the hubby went home to feed her stored milk. In his absence, the ER doctor returned to tell me that the scan showed I may have had a blood clot in my head. I was told I needed to be sent to the city hospital, Buffalo General, for further analysis. I called my husband and parents in tears.

The ambulance showed up before my husband could come back. The hubby scrambled to find someone to watch Coraline since she was not allowed in Buffalo General's ER. I was whisked through the ER admissions because of the severity of my condition. I was attached to a monitor and blood pressure cuff, and given pain and blood pressure medicine. Another CT was administered, this time showing no possibility of the blood clot. Relieved, but perplexed, the first ER doctor went off duty. The next one came on equally confused. They continued to monitor my pressure, which now read in the 180-190s, still unsure of why it could not be controlled.

After hours of waiting, with still no answers, the second ER was going to relent to letting me go. But a third ER doctor came on shift and suspected I was suffering from preeclampsia. At this point, my husband was waiting in the parking lot to take me home and I had already changed into my pants and sneakers, desperately wanting to go. I was willing to sign a release form to leave, despite the doctor's orders, but the 3rd ER doctor called my OB/GYN. After discussing my condition on the phone for twenty minutes, pacing in front of my ER door, he handed me his cell phone and she convinced me to stay a little longer to try a treatment of magnesium, which is commonly given to treat preeclampsia.

I called the hubby and told him to go home. In the meantime, the magnesium had reduced my blood pressure by thirty points, so Buffalo General had decided to send me back to the original hospital. The nurse said to me, "You know you're going to be picked up soon by ambulance and be transferred to the ICU," and I started to cry, wanting to know why. "This condition is very serious; it can be dangerous to your health." And so in less than a half hour, a new ambulance came to pick me up.

I learned from a search on my iPhone that preeclampsia was most common during pregnancy, but could occur after birth in a small minority of women, less than 5%. Usually when diagnosed in pregnancy, giving birth "cures" the condition; but they had no easy fix for people who suffered from the condition postpartum. It is most dangerous in the postpartum stage because it often goes undiagnosed since symptoms are often confused with usual postpartum problems. Left unchecked, preeclampsia can cause seizure, stroke, coma, or organ failure. This was why I was being sent to the intensive care unit. I arrived shortly after midnight, and I was immediately put on an IV drip of magnesium.

I called my husband at four in the morning after being admitted, checked out, and apprised of my condition. We were both very scared. We made arrangements for someone to watch Coraline for the following day, and once we realized I would not be leaving any time soon, my parents decided to come into town to help. Cora was not allowed to visit me in the hospital ICU, so my husband and I would video chat so I could still see her. It was heartbreaking to not be with her, especially when she seemed to stir at the sound of my voice.

They ran magnesium through an IV for a day and a half, as well as gave me fluids and pain medicine to control my blood pressure. Because it is so uncommon to be diagnosed with preeclampsia after birth, the doctors were concerned I may still be experiencing a blot clot or what they called brain push, so an MRI was ordered first thing Monday morning. Being on steady supply of magnesium felt like I was swimming underwater. My head continued to ache, but not as bad as it once was. Thankfully, the MRI on Monday showed no evidence of a clot or other brain abnormalities.

There is no test for preeclampsia; you need to have all the symptoms to be diagnosed. In my case, stomach cramps, severe headaches, high blood pressure, and leaking protein in my urine led to my diagnosis. At this point, I had been in the ICU for four days. All the while, I missed Coraline terribly; after all, at only two and half weeks old, she needed to be with her Mommy. My focus was on leaving the ICU to be with her, and I begged my doctor to let me go. My blood pressure was still reading in the 160s, so they gave me a booster shot of blood pressure medicine to bring it down more. By late afternoon, I was down to the 130-140s, and the doctor returned to tell me that they were allowing me to leave, although I had to promise to come into the office in a few days and do nothing but take care of Cora in the meantime.

Since then, I continue to have a headache, although not nearly as severe, and I continue to work on controlling my blood pressure which has yet to return to normal. We borrowed a blood pressure cuff to monitor things at home. I take medicine every six hours and I've been put on bed rest for six weeks. In theory, the condition should go away by then without any more medical intervention. Once we are able to control my blood pressure, the headaches should be gone completely.  Every few days, I am back at the doctor to reassess how things are going, and every time they warn me I am not out of the danger zone yet, and that I am still at risk for a seizure or stroke. I have never in my life wanted so terribly to be well again.

Thankfully, my hubby has helped tremendously in taking care of everything in our house, as well as taking care of Cora so I can get rest and feel better. Just a few days ago, I woke up to the two of them sleeping on the couch together, and I had to snap a picture:

Despite all the health troubles recently, I am truly grateful to be in my own home with my hubby and baby girl. I am hopeful the worst is behind me, and thankfully to my family for all their help. I realize things could be a lot worse, so I thank my lucky stars that I am on the mend. All the doctors tell me I have the right attitude, but honestly, I see no other choice: I have my little family depending on me to get better!

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